The product of eGFR and hemoglobin may help predict mortality in systolic heart failure patients without severe anemia and renal failure.
Turk Kardiyol Dern Ars
; 40(1): 9-15, 2012 Jan.
Article
em En
| MEDLINE
| ID: mdl-22395368
ABSTRACT
OBJECTIVES:
Cardiorenal anemia syndrome is defined in patients with heart failure (HF). Although individual influences of renal impairment and anemia were shown previously, complex interaction between the kidney, bone marrow, and the heart renders decision making relatively inefficient in patients with milder forms of these diseases. We aimed to investigate whether product of estimated glomerular filtration rate (eGFR) and hemoglobin (Hb) predicts outcomes in patients with HF. STUDYDESIGN:
The study included 148 consecutive patients (89 males, 59 females; mean age 68±10 years) who were hospitalized with acutely decompensated systolic HF and discharged alive. Discharge Hb levels were measured. Renal function was estimated via the MDRD (Modification of Diet in Renal Disease) formula. The eGFRxHb product was derived, and cut-off was defined using the ROC (receiver operating characteristic) analysis. The influence of eGFRxHb product on mortality was analyzed after a follow-up period of up to 34 months (mean 8.2±5.5 months).RESULTS:
The mean Hb was 12.7±2 g/dl, the mean creatinine was 105±46 µmol/l, and the mean eGFR was 61±23 ml/min/1.73 m². Eighty-two patients (55.4%) had an eGFR of <60 ml/kg/m². During the follow-up, 27 patients died. Optimal cut-off level of eGFRxHb product to predict mortality was found to be ≤788 with a sensitivity of 82.6% and specificity of 51.3%. In multivariate Cox proportional analysis, only eGFRxHb product ≤788 (HR 4.488, 95% CI 1.500-13.433, p=0.007) and presence of atrial fibrillation (HR 2.644, 95% CI 1.113-6.280, p=0.028) were independent predictors of mortality in patients with HF.CONCLUSION:
We concluded that the product of eGFR and Hb might be useful in prediction of mortality among patients with systolic HF.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Hemoglobinas
/
Insuficiência Cardíaca Sistólica
/
Taxa de Filtração Glomerular
Tipo de estudo:
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País/Região como assunto:
Asia
Idioma:
En
Revista:
Turk Kardiyol Dern Ars
Ano de publicação:
2012
Tipo de documento:
Article